Request for Employee Network/Email Account
PLEASE COMPLETE THIS FORM ON LINE,then return it to IT (AD 107) with a copy of the PCR work assignment. Incomplete/Ineligible data will delay the request.
 Control Number: E-332909
 Printed: Sunday, 6/25/2017
 Received by: _____,     /     /
Requested for:   ,      
(As in LACCD records)                        Last Name                                               First Name                                    M. Initial(If any,required)
Empl #:    Dept:    Building & Office:
Title:           LACCD Class code:
Acct. Type:   Administrator      Classified    Certificated          Unclassified
                    Student assistant Contractor with Other:
Assignment:  Full time              Part time     
Status:           Current Empl.      New Hire   Returning Empl.   Not a LACCD Empl.
Add. info:      Current assignment ends on
                     Reactivate account.
                     Transfered from another college within LACCD:
Voice mail:    Will use voice mail on ext. (1 ext with 1 user's voice mail)
      ?             Add to voice menu on shared ext. (1 ext w/several voice mails)
                     Need voice mail on new ext. # and phone (New full-time LACC position only).
                     No voice mail needed. Display ext. on Employee Phone directory.
Multiline phones; the extensions below should ring on line:
      ?              1     2     3     4     5     6
Requested by:  ,        
(Dept. Chair/Supervisor)         Last Name                                         First Name                                  Department                        Ext.

Employee is no longer working at LACC. Disable all his/her accounts.

Requested-by signature: __________________________    Date:
======   S t o p   - - -   D o   n o t   w r i t e   b e l o w   t h i s   l i n e   - - -   R e t u r n   f o r m   t o   I T   ======
IT Manager approval:   Signature: __________________________    Date: ___________
Manager's instructions:  ___________________________________________________________
IT Work Done:                Initials: _____ Date: ________                Initials: _____ Date: ________
DEC Usename: _____________
DEC missing, informed DO
DEC Psswrd Reset
UIA Usename: _____________
LACC Usename:____________
Acct. already exists
Certificated need to have DEC acct.
AD:in "Descript" enter "Acct. Type", "Dept"
Reactivated   Psswrd Reset
Expires: ______________
Groups: _________________
AD:Profile/LogonScript e76.bat
Campus directory verified
RightFax updated
Don't pre-expire Certificated accts
AD:Organization/Company is always "City"
Ext. _______ Menu # ____
     Handler: _______________
     Ext Recorder: ___________
Voice Mail #: ___________
     Prev. User: _____________
Email: Requestor, User
         Form Revised:   3/9/2007